PMID- 28971635
OWN - NLM
STAT- MEDLINE
DCOM- 20180713
LR  - 20180713
IS  - 1565-1088 (Print)
VI  - 19
IP  - 9
DP  - 2017 Sep
TI  - Ethnic Diversity and Increasing Resistance Patterns of Hospitalized
      Community-Acquired Urinary Tract Infections in Southern Israel: A Prospective
      Study.
PG  - 538-542
AB  - BACKGROUND: Little is known about the incidence of urinary tract infections (UTI)
      in the dispersed Bedouin population. UTIs are routinely treated empirically
      according to local resistance patterns, which is important when evaluating the
      risk factors and antibiotic resistance patterns in the Bedouin population.
      OBJECTIVES: To analyze risk factors, pathogens, and antibiotic resistance
      patterns of UTIs in the Bedouin population compared to the general population in 
      southern Israel. To compare data from this study to that from a previous study
      conducted at our center. METHODS: We prospectively followed all patients
      hospitalized with community acquired UTIs during a 4 month period at Soroka
      Medical Center. We also compared results from this study to those from a study
      conducted in 2000. RESULTS: The study comprised 223 patients: 44 Bedouin (19.7%),
      179 (80.3) non-Bedouin; 158 female (70.9%), 65 male (29.1). The Bedouin were
      younger (51.7 vs. 71.1 years of age, P < 0.001) and had a lower Charlson
      Comorbidity Index (2.25 vs. 4.87, P < 0.001). Enterobacteriaceae were the most
      common pathogens identified, and Escherichia coli (E. coli) was the most common
      with 156 (70%) strains identified, followed by Klebsiella spp. with 29 (13%),
      Proteus spp. with 18 (8%), pseudomonas with 9 (4%), and other bacteria including 
      enterococci with 11 (5%). The prevalence of E. coli increased significantly from 
      56% in 2000 to 70% in this study. We also noted an increase in community acquired
      extended spectrum beta lactamase (ESBL) pathogens from 4.5% in 2000 to 25.5% in
      the present study. No statistically significant difference was observed between
      the Bedouin and general populations in the causal pathogens, resistance to
      antibiotics, length of therapy, and readmission rate within 60 days. CONCLUSIONS:
      The Bedouin population hospitalized for UTIs is younger and presents with fewer
      co-morbidities. Isolated pathogens were similar to those found in the general
      population as was the presence of drug resistant infections. Overall, a
      substantial percentage of pathogens were resistant to standard first-line
      antibiotics, driving the need to change from empiric therapy to aminoglycoside
      therapy.
FAU - Elnasasra, Aref
AU  - Elnasasra A
AD  - Division of Internal Medicine, Soroka Medical Center and Faculty of Health
      Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel.
FAU - Alnsasra, Hilmi
AU  - Alnsasra H
AD  - Division of Internal Medicine, Soroka Medical Center and Faculty of Health
      Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel.
FAU - Smolyakov, Rozalia
AU  - Smolyakov R
AD  - Division of Internal Medicine, Soroka Medical Center and Faculty of Health
      Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel.
AD  - Infectious Disease Institute, Soroka Medical Center and Faculty of Health
      Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel.
FAU - Riesenberg, Klaris
AU  - Riesenberg K
AD  - Division of Internal Medicine, Soroka Medical Center and Faculty of Health
      Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel.
AD  - Infectious Disease Institute, Soroka Medical Center and Faculty of Health
      Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel.
FAU - Nesher, Lior
AU  - Nesher L
AD  - Division of Internal Medicine, Soroka Medical Center and Faculty of Health
      Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel.
AD  - Infectious Disease Institute, Soroka Medical Center and Faculty of Health
      Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel.
LA  - eng
PT  - Journal Article
PL  - Israel
TA  - Isr Med Assoc J
JT  - The Israel Medical Association journal : IMAJ
JID - 100930740
RN  - 0 (Anti-Bacterial Agents)
SB  - IM
MH  - Anti-Bacterial Agents/*therapeutic use
MH  - Arabs
MH  - Community-Acquired Infections/drug therapy/ethnology
MH  - *Drug Resistance, Bacterial
MH  - Escherichia coli
MH  - Escherichia coli Infections/drug therapy/ethnology
MH  - Female
MH  - Humans
MH  - Israel/ethnology
MH  - Male
MH  - Prospective Studies
MH  - Urinary Tract Infections/*drug therapy/ethnology
EDAT- 2017/10/04 06:00
MHDA- 2018/07/14 06:00
CRDT- 2017/10/04 06:00
PHST- 2017/10/04 06:00 [entrez]
PHST- 2017/10/04 06:00 [pubmed]
PHST- 2018/07/14 06:00 [medline]
PST - ppublish
SO  - Isr Med Assoc J. 2017 Sep;19(9):538-542.